Marine insurance and cargo claims by W E Cox Claims Group

FP Marine Claim Reporting Form

W E Cox Claims Group are pleased to offer this service to make life easier and quicker for you the claimant. Simply follow the sections below, completing as much information as possible, and submit. In 2 minutes your claim will be notified to the claims team and investigations will be undertaken immediately.

W E Cox Claims Group will treat this matter as a priority, and will issue you with an individual reference number, as soon as possible.

Section 1 of 4: Claimant Particular

Assured: Certificate Number: Contact Tel. Number: E-mail address:

Section 2 of 4: Shipment Details

Shipment: From To Shipment Number: Conveyance: Vehicle Type Vehicle ID Cargo:

Section 3 of 4: Claim Information

Claim Amount (in USD): Nature of Damage
/Loss: Details of Damage
/Loss: Date of Damage
/Loss Discovered (dd/mm/yyyy):

Current location of the damaged cargo / loss discovered : Corresponding Region:

Please state the contact details of the cargo receiver:

Name: Address: Telephone number: Email Address:

Section 4 of 4: Claim Documents

I confirm I have attached the following documents:

Certificate of Insurance: Inventory List/Invoice: Documentary evidence to show the extent of the damage or loss (e.g. Claused Delivery Receipt): Photos of damaged items taken at the time of delivery/ devanning: Bill of Lading/Air WayBill/Contract of Carriage: Packing List: Others:

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FP Marine Claim Reporting Form

Section 1 of 4: Claimant Particular

Section 2 of 4: Shipment Details

Section 3 of 4: Claim Information

Section 4 of 4: Claim Documents